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基于问卷调查对德国儿童药物过敏反应的终生患病率及特征进行的研究。

Questionnaire-based survey of lifetime-prevalence and character of allergic drug reactions in German children.

作者信息

Lange L, Koningsbruggen S V, Rietschel E

机构信息

Children's Hospital, University of Cologne, Cologne, Germany.

出版信息

Pediatr Allergy Immunol. 2008 Nov;19(7):634-8. doi: 10.1111/j.1399-3038.2007.00702.x. Epub 2008 Jan 22.

Abstract

Data on the epidemiology of adverse drug reactions (ADR), especially allergic drug reactions, in children are rare. The reported prevalence of ADR in pediatric populations varies a lot, depending on type of the study and the country where the data were collected. In order to assess the prevalence of ADR and allergic drug reactions in a population of German children, we conducted a study in a German pediatric university hospital. A questionnaire concerning occurrence and character of ADR was distributed to all parents presenting their children in the hospital for planned admissions or in the emergency department from May 2004 to November 2004. Additional telephone interviews were conducted to specify the reported symptoms in ambiguous cases. One thousand four hundred forty-seven questionnaires were collected. The reported life-time prevalence of ADR according to the information given by the parents was 7.5% (108/1447). Six of the reactions were severe, three children had experienced anaphylactic reactions. In 4.2% (61/1447), the history was suspicious for a potential allergic mechanism because of an immediate or late phase cutaneous drug reaction. In this group, the suspected drugs were antibiotics in 85% (32.7% aminopenicillins, 29.5% other penicillins, 11.5% cefaclor, 8.2% macrolides and 18% others), antiphlogistic and respiratory drugs in 4.9% each and vaccines and contrast media in 3.3% each. There was a higher percentage of children under the age of four suffering from ADR. This trend was not significant when analyzing only the allergic reactions. Forty-four percent of the parents stated, their children suffer from drug allergy, although a clear non-allergic reaction was described. Both, ADR and allergic drug reactions are frequent phenomena in children. It is important to monitor drug therapy for any adverse reaction in order to inform the parents about the character of the adverse reaction, the necessary consequences and to initiate further diagnostic procedures.

摘要

关于儿童药物不良反应(ADR),尤其是药物过敏反应的流行病学数据很少。报道的儿科人群中ADR的患病率差异很大,这取决于研究类型和收集数据的国家。为了评估德国儿童人群中ADR和药物过敏反应的患病率,我们在一家德国儿科大学医院进行了一项研究。2004年5月至2004年11月期间,向所有带孩子到医院进行计划入院或在急诊科就诊的家长发放了一份关于ADR发生情况和特征的问卷。对于情况不明确的病例,还进行了额外的电话访谈以明确所报告的症状。共收集到1447份问卷。根据家长提供的信息,报告的ADR终生患病率为7.5%(108/1447)。其中6例反应严重,3名儿童经历过过敏反应。在4.2%(61/1447)的病例中,由于即刻或迟发性皮肤药物反应,病史可疑为潜在的过敏机制。在这组病例中,可疑药物为抗生素的占85%(氨青霉素占32.7%,其他青霉素占29.5%,头孢克洛占11.5%,大环内酯类占8.2%,其他占18%),抗炎药和呼吸系统药物各占4.9%,疫苗和造影剂各占3.3%。4岁以下儿童发生ADR的比例较高。仅分析过敏反应时,这一趋势并不显著。44%的家长表示他们的孩子患有药物过敏,尽管描述的是明确的非过敏反应。ADR和药物过敏反应在儿童中都是常见现象。监测药物治疗中的任何不良反应很重要,以便告知家长不良反应的特征、必要的后果并启动进一步的诊断程序。

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